ASN Report 2017

29 ASN report on the state of nuclear safety and radiation protection in France in 2017 For more than a century, medicine has made use of various sources of ionising radiation, both for diagnostic purposes and for therapy. While their benefits and usefulness have long been medically proven, these techniques however contribute significantly to the population’s exposure to ionising radiation. Behind exposure to natural ionising radiation, medical exposure represents the second source of exposure for the population and the leading source of artificial exposure. Protection of the patients benefiting frommedical imaging examinations or therapeutic care using ionising radiation is regulated by the Public Health Code, while that of personnel working in the corresponding facilities is regulated by the Labour Code. In France, there are several thousand conventional or dental radiology devices, just over a thousandcomputed tomography facilities, more than a thousand facilities carrying out interventional radiology and fluoroscopy-guided procedures, 232 nuclearmedicine units using unsealed sources for in vivo or in vitro diagnostics and for internal radiotherapy. In addition, as at the end of 2017, 172 external radiotherapy centres equipped with 476 treatment devices, handling some 200,000 patients every year, were identified by ASN. 750 radiation oncologists were listed. Nuclear medicine comprises about 700 specialist practitioners, along with another 1,000 physicians from other 09 Medical uses of ionising radiation specialities working together in nuclear medicine units (residents, cardiologists, endocrinologists, etc.) In 2017, ASN issued 634 licenses, of which 56%were in computed tomography, 24% innuclearmedicine, 16% in external-beam radiotherapy and 4% in brachytherapy. Significant Radiation Protection Events (ESR) in 2017 Remote-notification of significant events via a single vigilance portal created by the Ministry for Solidarity and Health was extended to the entire medical field in April  2017. Since 2012, the number of events notified to ASN stands at about 500 per year. In 2017, the number of ESRs notified to ASN in themedical field increased (568 in 2017 as opposed to 493 in 2016). This rise is mainly due to a large number of notified events in radiology (conventional and computed tomography) and, to a lesser extent, in nuclear medicine. On the other hand, the number of events notified in radiotherapy has been gradually falling for the past two years (about 150 in  2016 and  2017 as against about 240 from2008 until 2015). About 80% of the events notified come from computed tomography (29%), radiotherapy (25%) and nuclear medicine (26%) units. The events notified in the medical field mainly concern exposure of patients (53%) and foetuses in women unaware that they were pregnant (30%), this latter category seeing a significant rise (with no consequences for the unborn child). regions. They check application within these installations of the regulations relative to nuclear safety and radiation protection, to pressure equipment and to Installations Classified for Protection of the Environment. They ensure labour inspectorate duties in the nuclear power plants. In radiological emergency situations, the ASN regional divisions check the on-site measures taken by the licensee to make the installation safe and assist the Prefect of the département , who is responsible for protection of the population. To ensure preparedness for these situations, they help prepare the emergency plans drafted by the Prefects and take part in the periodic exercises. The ASN regional divisions contribute to the public information duty. They for example take part in the meetings of the Local Information Committees of the BNIs, and maintain regular relations with the local media, elected officials, associations, licensees and local administrations. This chapter presents ASN’s overall assessment by broad sector of activity as well as its assessment of nuclear safety and radiation protection in each region. It also reports on the local issues and procedures that are particularly representative of the regional action of ASN, especially with regard to informing the public and cross-border relations. Significant events and outlook